PRP161: Subjective verses Objective Walkability and Knee Osteoarthritis Symptoms

Sarah Gebauer, MD, MSPH, MSPH; Joanne Salas, MPH; Jeffrey Scherrer, PhD; Jessica McGee, MPH; Navneesh Pandher


Context: Osteoarthritis (OA) is one of the most common debilitating conditions in the United States. Many treatments pose risks or have poor efficacy, but walking is a low risk, inexpensive and effective means of reducing pain, increasing function and slowing OA progression. Many individuals with OA do not meet physical activity recommendations and this may be due to walkability. Little is known about whether objectively vs. subjective walkability is more strongly associated with OA severity.
Objective: Compare objective verses subjective walkability and association with knee OA severity
Study Design: Cross-sectional
Setting or Dataset: 3 academic primary care clinics in St. Louis, MO, USA. Exposure was walkability, measured either by geocoded Walkscore©, an objective, proprietary walkability score, or NEWS-A, a subjective, validated walkability score.
Population Studied: Adults age 45 to 90 years with ICD-9 code for knee osteoarthritis and no history of replacement recruited from academic primary care practices
Outcome Measures: Western Ontario and McMaster University Osteoarthritis Severity Index (WOMAC) as a continuous score
Results: Data collection is ongoing. Preliminary sample of n=58 for Walkscore© and n=77 for NEWS-A (same population pool). Adjusted analysis via linear regression showed objective walkability was not associated with increasing OA severity (B=0.11; 95% CI: -0.07, 0.29; p=0.217), but subjective walkability, particularly increasing street connectivity perception, was associated with decreased knee OA severity
(B=-6.28; 95% CI: -11.82, -0.74; p=0.027). The strongest predictor in both analyses was self-reported pain score (p<0.0001).
Conclusions: Preliminary data suggest that perception of neighborhood qualities may be associated more strongly with OA severity than objective walkability. Further data collection is underway to improve power and allow for further exploration.

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